Fadiga em celíacos: avaliação da intensidade e impacto

Abstract

The present study aimed to analyze fatigue in individuals with celiac disease. It was a crosssectional study, in an exploratory type, with a quantitative approach, performed with celiac, during May 2012 to September 2017, through interviews based on a data collection instrument, considering sociodemographic and clinical variables. The analysis was made by the calculation of absolute frequencies, percentages, measures of central tendency and dispersion. Besides, to evaluate the association between clinical variables and fatigue, the Fisher's Exact Probability Test and the Chi-Square Test were applied, when expected frequencies greater than five. The calculation of the prevalence ratio measured the Prevalence Ratio. In the mean difference analysis, the Kolmogorov-Smirnov tests were used to verify the normality of the data, and the Levene test was used to verify homoscedasticity. Based on the results of these tests, the MannWhitney test was used to verify the difference of the mean of the stations between the groups, with a significance level of 0.05. The recommendations of the resolution 466/2012 were fulfilled. We interviewed 83 predominantly white celiac women, residents of Fortaleza, aged 33, on average, reported not having a partner, 18 years of education, paid employment, an income of up to R $ 2,650.00 and participated in associations of support. Fatigue was present in 73.8% of the population and moderate intensity. Regarding the impact of fatigue, the coeliacs reported doing almost everything they did habitually. The clinical variables that presented the highest prevalence were "cross-contamination" (84.5%) and "difficulties to follow the therapeutic regimen" (54.8%). In the presence of the variable "insufficient knowledge," the average number of impact stations was lower. Celiacs that did not have the habit of recognizing establishments, which considered as obstacles the taste or appearance of gluten-free foods and individual income were insufficient, showed 4.86, 6.8 and 3.2 times more likely to present fatigue. Celiacs that considered as obstacles the taste or appearance of gluten-free foods and individual income are insufficiently presented 6.8 and 3.2 times more chance of presenting fatigue, respectively. Celiacs who believed that in the presence of negative small intestine biopsy results could eat or insert gluten in their diet. Those who claimed that gluten is present in cereals such as wheat, rye, rice, corn and barley, and those who believed that when ingesting gluten and did not show symptoms of celiac disease and intestinal lesion presented a mean number of posts more significant concerning the impact. Celiacs who believed they could use gluten meal substitutes showed less intense fatigue and low impact on daily activities. Gastrointestinal and neurological symptoms were the most prevalent with 83% and 79.8%, respectively. Celiacs who had musculoskeletal symptoms were 5.3 times more likely to develop fatigue. In this way, it was noticed that some variables that reflect behaviors and knowledge increased the chance of the development of fatigue. Regarding such a common symptom, it is necessary to the nursing professionals to have a better knowledge of it, so the care for the celiac patient is complete and holistic, relieving fatigue and increasing the quality of life.